Remote Medicaid Payment Analytics Lead

Optum; Washington (District of Columbia); Remote; USD 113,000 - 193,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase plan

401k contribution

Job summary

Optum Serve Consulting/The Lewin Group (OSC/Lewin) seeks a Health Data Analytics Consultant to analyze Medicaid data (TAF/TAF) and translate policy into analytic specs for CMS Innovation Center models. You will develop SQL code, apply Python tools, and support attribution, payment calculations, and quality measures.

The role offers remote work from anywhere in the U.S. with office presence in the DC/Minneapolis area as needed, and requires collaboration with senior analysts and project

Qualifications

• 3+ years of experience working with healthcare data.
• 1+ year of direct experience working with Medicaid data.
• Experience conducting quantitative analysis using healthcare claims and enrollment data.
• Experience translating business, policy, or program requirements into analytic specifications.
• Understanding of Medicaid eligibility, enrollment, claims, and encounter data.
• Familiarity with Medicaid payment and delivery systems, including managed care and fee-for-service environments.
• Proven excellent oral and written communication skills and a focus on meeting deadlines.
• Demonstrated attention to detail and commitment to producing accurate, high-quality work.

Responsibilities

• Conduct hands-on analysis of Medicaid data, including T-MSIS data, to support payment model implementation and operations.
• Translate policy and methodology into data specifications, business rules, and analytic code.
• Develop, test, and maintain SQL code to build analytic files, define populations, and produce model outputs.
• Use Python and other analytic tools to support data processing, analysis, and quality assurance.
• Support attribution, payment calculation, quality measurement, and other operational methodologies used in healthcare payment models.
• Assess Medicaid data quality and completeness across states and delivery systems.
• Analyze Medicaid claims, encounter, enrollment, provider, and other program data for client needs.
• Develop and maintain documentation of specifications, methodologies, code, assumptions, and QC procedures.
• Perform quality assurance reviews and validation checks on analytic outputs and deliverables.
• Prepare tables, reports, and presentations for technical and non-technical audiences.
• Collaborate with policy, operations, and analytic staff as a project team member.

Skills

Healthcare data

Medicaid data

SQL

Python

Data analysis

Communication skills

Attention to detail

Tools

Snowflake

Databricks

CMS IDR

T-MSIS

Job description

Optum Serve Consulting/The Lewin Group (OSC/Lewin) seeks a Health Data Analytics Consultant to analyze Medicaid data (TAF/TAF) and translate policy into analytic specs for CMS Innovation Center models. You will develop SQL code, apply Python tools, and support attribution, payment calculations, and quality measures.

The role offers remote work from anywhere in the U.S. with office presence in the DC/Minneapolis area as needed, and requires collaboration with senior analysts and project